PHILOSOPHY AND THEORETICAL FRAMEWORK FOR COMMUNITY HEALTH

NURSING PRACTICE
DEFINITIONS
A philosophy is a set o syste! o" #elie"s that po$i%es a #asis a&% '(i%e "o
a)tio&* A& i&%i$i%(al+ a 'o(p+ a& o'a&i,atio& o a po"essio& )a& ha$e a philosophy that
i&)l(%es 'e&eal #elie"s+ )o&)epts+ attit(%es+ ethi)al )o&si%eatio&s a&% '(i%eli&es+ as -ell
as $al(es that e.plai& the -ay a li"e is li$e%+ o the !a&&e i& -hi)h a& o'a&i,atio& is
(& o ho- a po"essio& is pa)ti)e%* A philosophy is %ei$e% "o! e.peie&)e a&% the
)o&te!plati$e )o!paiso&s o" o&e/s e.peie&)es -ith those o" othes*
A theoeti)al "a!e-o0+ as it applies to the pa)ti)e o" a po"essio&+ e"es to the
#asi) st()t(e o" i%eas+ )o&)epts+ #elie"s a&% pi&)iples popose% o "ollo-e% as the #asi)
)o&%()t o" the pati)(la po"essio&*
Philosophy a&% theoeti)al "a!e-o0 ae elate% a&% )o!ple!e&tay te!s as
they #oth e!#o%y a syste! o" #elie"s a&% )o&)epts that po$i%e '(i%es to a&% #ases "o
a)tio&*
RATIONALE
1oth philosophy a&% theoeti)al "a!e-o0 "o the pa)ti)e o" a po"essio&
po$i%e '(i%es a&% #ases "o the pati)(la -ay the pa)titio&es o" the po"essio&
)o&%()t its #(si&ess* They po$i%e %ie)tio&+ li0e a (%%e to a ship+ a&% e.plai& the what+
the why a&% the how o" thei a)ti$ities*
1ei&' a-ae o" the philosophy a&% theoeti)al "a!e-o0 "o pa)ti)e o" a
po"essio& !a0es the a)tio& o" pa)titio&es -ell2%ie)te%+ p(posi$e a&% syste!ati)+ a&%
)o&se3(e&tly po%()ti$e a&% e""e)ti$e* Othe-ise+ o&e !ay 4(st )ay o(t tas0s a&%
a)ti$ities as a !atte o" o(ti&e+ o si!ply #y "ollo-i&' o%es "o! s(peios -itho(t
0&o-i&' the -hys a&% -hee"oes o" s()h tas0s a&% a)ti$ities* A)ti$ities )aie% o(t as a
!atte o" o(ti&e !ay o !ay &ot po%()e %esia#le a&% #e&e"i)ial o(t)o!es a&% )a&
o"te& #e a -aste o" ti!e a&% e""ot*
PHILODOPHY FOR COMMUNITY HEALTH NURSING PRACTICE
The "ollo-i&' #elie"s '(i%e the pa)ti)e o" )o!!(&ity health &(si&' 5CHN67
8* N(si&' is a (&i3(e a&% %isti&)t )o!po&e&t o" health )ae* The &(se shaes
espo&si#ility "o )ae o" i&%i$i%(al )lie&ts9 patie&ts+ "a!ilies+ spe)i"i) pop(latio&
'o(ps a&% the )o!!(&ist as a -hole -ith othe !e!#es o" the health tea! a&%
has a (&i3(e oles a&% "(&)tio&s to )o&ti#(te to the a)hie$e!e&t o" the 'oal o" a
healthy a&% po%()ti$e )o!!(&ity*
:* CHN s(#s)i#es to the philosophy o" i&te%epe&%e&)e a!o&' the health
po"essio&s* No si&'le health po"essio& o %is)ipli&e )a& sol$e all the health
po#le!s o" a )o!!(&ity* The &(se -o0s )olla#oati$ely -ith othe !e!#es
o" the health tea! as -ell as !e!#es o" elate% i&tese)toal tea!s i& a spiit o"
tea!-o0 a&% (si&' the tea! appoa)h to health )ae %eli$ey*
;* As a spe)ial "iel% o" &(si&' pa)ti)e+ CHN shaes the h(!a&isti) #elie"s a&%
$al(es o" the &(si&' po"essio&* It $ie-s a& i&%i$i%(al )lie&t9patie&t as a (&i3(e
-hole h(!a& #ei&' -ith physi)al+ psy)hoso)ial a&% spiit(al &ee%s+ a&% as a
!e!#e o" a "a!ily+ a spe)i"i) pop(latio& 'o(p a&% a )o!!(&ity* It $ie-s the
"a!ily as the (&it o" )ae i& the pa)ti)e o" CHN* It (phol%s the %i'&ity o" the
h(!a& #ei&' a&% espe)ts the i'hts o" i&%i$i%(al )lie&ts9patie&ts a&% "a!ilies to
#e teate% a&% se$e% -ith )o(tesy+ espe)t+ 0i&%&ess a&% )o!passio&+ espe)ially
i& !o!e&ts o" pai& o s(""ei&'*
<* CHN #elie$es i& the pi!a)y o" health as a 'oal a&% as esse&tial ele!e&t that
a""e)ts the 3(ality o" li"e o" i&%i$i%(als+ "a!ilies+ 'o(ps a&% )o!!(&ities* Goo%
health is a e3(isite to %e$elop!e&t o" people a&% )o!!(&ities*
=* The 'oal o" &(si&' is i&%epe&%e&)e a&% sel"2elia&)e i& health )ae "o the )lie&t9
patie&t2 #e it a& i&%i$i%(al+ a "a!ily+ a 'o(p o the -hole )o!!(&ity* I& elatio&
to this 'oal+ CHN #elie$es i& the )apa)ity o" people a&% )o!!(&ities to )ha&'e
"o the #ette+ 'i$e& the i'ht a&% a%e3(ate a!o(&t o" i&"o!atio&+ !oti$atio& a&%
assista&)e*
>* N(si&'+ i& 'e&eal+ a&% CHN i& pati)(la+ e)o'&i,es the elatio&ship o" &o&2
health i&te$e&tio&s i& the sol(tio& o" health po#le!s*
?* To a)hie$e the 'oal o" )o!!(&ity health+ the &(se -o0s with, &ot for, i&%i$i%(al
)lie&ts9patie&ts+ "a!ilies+ spe)i"i) pop(latio& 'o(ps a&% the )o!!(&ity at la'e*
This i!plies that the )lie&t9 patie&t is a& active participant i& the %e)isio&2!a0i&'
a&% )ae po)esses+ &ot a passi$e e)ipie&t o" )ae* The e)ipie&t o" )ae sho(l% #e
'i$e& !a.i!(! oppot(&ities to pati)ipate i& the pla&&i&'+ i!ple!e&tatio& a&%
e$al(atio& o" )ae*
@* N(si&' 'oals a&% sta&%a%s o" )ae sho(l% )o&si%e )o&stai&ts i!pose% #y
)lie&t+ health a'e&)y a&% )o!!(&ity eso()es* The &(se &ee%s to set ealisti)+
'oals+ ta'ets a&% sta&%a%s o" )ae i& )o&si%eatio& o" a$aila#le eso()es i&
he9his pla)e o" pa)ti)e*
A* CHN pa)ti)e is &ot a #o%y o set o" the sa!e epeati&' tas0s* What &(ses %o
$aies a))o%i&' to pla)e a&% ti!e* The )o&te&t+ appoa)h a&% pioities i&
pa)ti)e &ee% )o&sta&t eassess!e&t a&% a%4(st!e&t #ase% o& )lie&t &ee%s a&%
)o&te.t o" pa)ti)e*
8B* N(ses ha$e the espo&si#ility to 0eep thei 0&o-le%'e a&% s0ills )(e&t a&% (p2
to2%ate a))o%i&' to %e$elop!e&ts i& &(si&'+ p(#li) health a&% othe elate%
s)ie&)es* They a)hie$e this e3(ie!e&t tho('h sel"2st(%y a&% atte&%a&)e i&
)o&ti&(i&' e%()atio& po'a!s*
PROPOSED THEORETICAL FRAMEWORK FOR CHN PRACTICE
As a #le&% o" &(si&' a&% p(#li) health CHN (tili,es a&% applies the )o&)epts+
pi&)iples+ !etho%s a&% tools o" these t-o s)ie&)es to eali,e the 'oal o" health "o
i&%i$i%(al )lie&ts9patie&ts+ "a!ilies+ spe)i"i) pop(latio& 'o(ps a&% the )o!!(&ity as a
-hole*
The popose% theoeti)al "a!e-o0 %e"i&es the "ollo-i&'7
8* The le$els o" )lie&tele o" the )o!!(&ity health &(se2 Cae !ay #e "o)(se% o&
a&% %eli$ee% to a& i&%i$i%(al )lie&t9patie&t+ a "a!ily+ a spe)i"i) pop(latio& 'o(p
o the )o!!(&ity at la'e*
:* The o#4e)ti$es o" )ae+ -hi)h is prevention, a&0e% a))o%i&' to "i$e le$els a&%
a%%esse% to eithe a& i&%i$i%(al+ a "a!ily+ a spe)i"i) pop(latio& 'o(p o the
)o!!(&ity as a -hole*
;* Metho%olo'y "o pa)ti)e2 The &(si&' po)ess+ applie% to the "o( le$els o"
)lie&teleCeithe a& i&%i$i%(al )lie&t9patie&t+ a "a!ily+ a spe)i"i) pop(latio& 'o(p
o the -hole )o!!(&ity*
<* Pioities "o )aeCIt is &ot possi#le "o a )o!!(&ity health &(se to po$i%e
se$i)e to e$ey i&%i$i%(al+ "a!ily+ o 'o(p i& the )o!!(&ity -ho !ay &ee% o
%e!a&% &(si&' )ae* To i%e&ti"y pioities "o )ae+ she9he (tilities the is0
appoa)h+ i*e* %eli$ei&' )ae to those at 'eatest is0 o" %e$elopi&' a %isease o
othe health po#le!s*
=* Appoa)h to health )ae %eli$ey D The )o!!(&ity health &(se is a pat o" health
tea! -ith spe)i"i) oles a&% "(&)tio&s i& the a)hie$e!e&t o" the 'oal o"
)o!!(&ity health %e$elop!e&t* She9he -o0s i& )oopeatio& a&% )oo%i&atio&
-ith othe !e!#es o" the health tea!+ "(lly a-ae o" he o-& (&i3(e
)o&ti#(tio&+ as -ell as ea)h tea!/s !e!#e/s %isti&)t oles a&% "(&)tio&s*
The "a!e-o0 po$i%es %ie)tio& a&% '(i%eli&es to the )o!!(&ity health &(se
i& te!s o" who o to whom she is 'i$i&' )ae 5le$els o" )lie&tele6+ who sho(l% e)ei$e
)ae i& the "a)e o" li!ite% ti!e a&% eso()es 5those at 'eatest is0 to %e$elop a 'i$e&
health po#le!6+ the why o o#4e)ti$es o" he9his a)tio&s a&% i&te$e&tio& !eas(es
5le$el o" pe$e&tio&6+ a&% the how o" po$i%i&' )ae a&% %eli$ei&' &(si&' se$i)es
5tho('h the (se o" &(si&' po)ess a&% the tea! appoa)h to )ae6*
Use a&% appli)atio& o" the philosophy a&% theoeti)al "a!e-o0 "o CHN
pa)ti)e -o(l% #olste/s &(si&'/s )lai! as a po"essio&+ a&% !a0e a %isti&)tio&
#et-ee& po"essio&al &(si&' )ae a&% &(si&' )ae po$i%e% #y people a&% a(.iliay
health -o0es*